Deliverable surgical instrument

ABSTRACT

In various embodiments, a shaftless end effector is disclosed. The end effector can comprise an anvil assembly including a staple forming surface. The end effector can also comprise a staple cartridge channel configured to receive a staple cartridge therein. The end effector can include a closure system configured to close the anvil. In various instances, the closure system can also form the staples contained within the staple cartridge. The end effector can also include a cutting member configured to cut tissue positioned intermediate the anvil and the staple cartridge. In various instances, the cutting member can be actuated by the closure system. In other instances, the end effector can include an independent system for actuating the cutting member. In various instances, the end effector can be delivered to a surgical site through a trocar and then operated by one or more actuators that are assembled to the end effector.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation application claiming priority under35 U.S.C. § 120 to U.S. patent application Ser. No. 14/178,840, entitledDELIVERABLE SURGICAL INSTRUMENT, filed Feb. 12, 2014, now U.S. PatentApplication Publication No. 2015/0223809, the entire disclosure of whichis hereby incorporated by reference herein.

BACKGROUND

The present application relates to surgical instruments and, in variousembodiments, to surgical stapling and/or cutting instruments and staplecartridges for use therewith.

BRIEF DESCRIPTION OF THE DRAWINGS

The features and advantages of this invention, and the manner ofattaining them, will become more apparent and the invention itself willbe better understood by reference to the following description ofembodiments of the invention taken in conjunction with the accompanyingdrawings, wherein:

FIG. 1 is a cross-sectional view of a shaftless surgical systemincluding a shaftless end effector in accordance with at least oneembodiment;

FIGS. 2-6 illustrate various cross-sectional views of the shaftlesssurgical system of FIG. 1;

FIG. 7 is a cross-sectional view of the end effector of FIG. 1 in anopen condition, wherein the end effector includes an anvil in an openposition;

FIG. 8 is a cross-sectional view of the end effector of FIG. 1 in aclosed condition;

FIG. 9 is a cross-sectional view of the end effector of FIG. 1illustrating a closure system of the end effector engaged with theanvil;

FIG. 10 is a cross-sectional view of the end effector of FIG. 1 in afired condition;

FIG. 11 is a cross-sectional view of a shaftless end effector inaccordance with at least one alternative embodiment and a grasperconfigured to manipulate the end effector;

FIG. 12 is a cross-sectional view of a shaftless end effector inaccordance with at least one alternative embodiment and an actuatorconfigured to manipulate the end effector;

FIG. 13 illustrates the actuator of FIG. 12 detached from the endeffector of FIG. 12;

FIG. 14 is a cross-sectional view of an end effector in accordance withat least one embodiment comprising a detachable guide tether;

FIG. 15 is a detail view of a frangible section connecting the guidetether of FIG. 14 to the end effector of FIG. 14;

FIG. 16 illustrates the detachable guide tether of FIG. 14 in a detachedstate;

FIG. 17 is a cross-sectional view of a shaftless end effector inaccordance with at least one alternative embodiment including arotatable drive system;

FIG. 18 is a cross-sectional view of a knife member of the end effectorof FIG. 17;

FIG. 19 is a cross-sectional view of the end effector of FIG. 17illustrated in a fired condition;

FIG. 20 is a cross-sectional end view of the end effector of FIG. 17;

FIG. 21 is a cross-sectional view of the end effector of FIG. 17illustrated with the knife member of FIG. 18 in a fully-actuatedposition;

FIG. 22 is a cross-sectional view of a shaftless end effector inaccordance with at least one alternative embodiment comprising arotatable closure system and a firing system;

FIG. 23 is a cross-sectional view of a knife member of the end effectorof FIG. 22;

FIG. 24 is a cross-sectional end view of the end effector of FIG. 22;

FIG. 25 is a cross-sectional view of the end effector of FIG. 22illustrated in a closed and fully-fired condition;

FIG. 26 is a cross-sectional view of the end effector of FIG. 22illustrated in a fully-actuated condition;

FIG. 27 illustrates an embodiment of an integrated closure and firingmechanism for interfacing with a shaftless end effector;

FIG. 28 illustrates one embodiment of a shaftless end effectorconfigured to be operably engaged with the integrated closure and firingmechanism of FIG. 27;

FIG. 29 illustrates the integrated closure and firing mechanism of FIG.27 attached to the end effector of FIG. 28;

FIG. 30 illustrates the shaftless end effector of FIG. 28 in a closedcondition;

FIGS. 31-32 illustrate various cross-sectional views of the shaftlessend effector of FIG. 28; and

FIG. 33 illustrates the end effector of FIG. 28 in a partially-actuatedcondition.

DETAILED DESCRIPTION

The Applicant of the present application also owns the U.S. patentapplications identified below which are each herein incorporated byreference in their respective entirety:

U.S. patent application Ser. No. 12/894,311, entitled SURGICALINSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS; now U.S. Pat. No.8,763,877;

U.S. patent application Ser. No. 12/894,340, entitled SURGICAL STAPLECARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICALSTAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS; now U.S. Pat.No. 8,899,463;

U.S. patent application Ser. No. 12/894,327, entitled JAW CLOSUREARRANGEMENTS FOR SURGICAL INSTRUMENTS; now U.S. Pat. No. 8,978,956;

U.S. patent application Ser. No. 12/894,351, entitled SURGICAL CUTTINGAND FASTENING INSTRUMENTS WITH SEPARATE AND DISTINCT FASTENER DEPLOYMENTAND TISSUE CUTTING SYSTEMS; now U.S. Pat. No. 9,113,864;

U.S. patent application Ser. No. 12/894,338, entitled IMPLANTABLEFASTENER CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT; now U.S. Pat. No.8,864,007;

U.S. patent application Ser. No. 12/894,369, entitled IMPLANTABLEFASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER; now U.S. PatentApplication Publication No. 2012/0080344;

U.S. patent application Ser. No. 12/894,312, entitled IMPLANTABLEFASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS; now U.S. Pat. No.8,925,782;

U.S. patent application Ser. No. 12/894,377, entitled SELECTIVELYORIENTABLE IMPLANTABLE FASTENER CARTRIDGE; now U.S. Pat. No. 8,393,514;

U.S. patent application Ser. No. 12/894,339, entitled SURGICAL STAPLINGINSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT; now U.S. Pat.No. 8,840,003;

U.S. patent application Ser. No. 12/894,360, entitled SURGICAL STAPLINGINSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM; now U.S. Pat. No.9,113,862;

U.S. patent application Ser. No. 12/894,322, entitled SURGICAL STAPLINGINSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS; now U.S.Pat. No. 8,740,034;

U.S. patent application Ser. No. 12/894,350, entitled SURGICAL STAPLECARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES; now U.S. PatentApplication Publication No. 2012/0080478;

U.S. patent application Ser. No. 12/894,383, entitled IMPLANTABLEFASTENER CARTRIDGE COMPRISING BIOABSORBABLE LAYERS; now U.S. Pat. No.8,752,699;

U.S. patent application Ser. No. 12/894,389, entitled COMPRESSIBLEFASTENER CARTRIDGE; now U.S. Pat. No. 8,740,037;

U.S. patent application Ser. No. 12/894,345, entitled FASTENERSSUPPORTED BY A FASTENER CARTRIDGE SUPPORT; now U.S. Pat. No. 8,783,542;

U.S. patent application Ser. No. 12/894,306, entitled COLLAPSIBLEFASTENER CARTRIDGE; now U.S. Pat. No. 9,044,227;

U.S. patent application Ser. No. 12/894,318, entitled FASTENER SYSTEMCOMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS; now U.S.Pat. No. 8,814,024;

U.S. patent application Ser. No. 12/894,330, entitled FASTENER SYSTEMCOMPRISING A RETENTION MATRIX AND AN ALIGNMENT MATRIX; now U.S. Pat. No.8,757,465;

U.S. patent application Ser. No. 12/894,361, entitled FASTENER SYSTEMCOMPRISING A RETENTION MATRIX; now U.S. Pat. No. 8,529,600;

U.S. patent application Ser. No. 12/894,367, entitled FASTENINGINSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTIONMATRIX; now U.S. Pat. No. 9,033,203;

U.S. patent application Ser. No. 12/894,388, entitled FASTENER SYSTEMCOMPRISING A RETENTION MATRIX AND A COVER; now U.S. Pat. No. 8,474,677;

U.S. patent application Ser. No. 12/894,376, entitled FASTENER SYSTEMCOMPRISING A PLURALITY OF FASTENER CARTRIDGES; now U.S. Pat. No.9,044,228;

U.S. patent application Ser. No. 13/097,865, entitled SURGICAL STAPLERANVIL COMPRISING A PLURALITY OF FORMING POCKETS; now U.S. Pat. No.9,295,464;

U.S. patent application Ser. No. 13/097,936, entitled TISSUE THICKNESSCOMPENSATOR FOR A SURGICAL STAPLER; now U.S. Pat. No. 8,657,176;

U.S. patent application Ser. No. 13/097,954, entitled STAPLE CARTRIDGECOMPRISING A VARIABLE THICKNESS COMPRESSIBLE PORTION; now U.S. PatentApplication Publication No. 2012/0080340;

U.S. patent application Ser. No. 13/097,856, entitled STAPLE CARTRIDGECOMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF; nowU.S. Patent Application Publication No. 2012/0080336;

U.S. patent application Ser. No. 13/097,928, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING DETACHABLE PORTIONS; now U.S. Pat. No. 8,746,535;

U.S. patent application Ser. No. 13/097,891, entitled TISSUE THICKNESSCOMPENSATOR FOR A SURGICAL STAPLER COMPRISING AN ADJUSTABLE ANVIL; nowU.S. Pat. No. 8,864,009;

U.S. patent application Ser. No. 13/097,948, entitled STAPLE CARTRIDGECOMPRISING AN ADJUSTABLE DISTAL PORTION; now U.S. Pat. No. 8,978,954;

U.S. patent application Ser. No. 13/097,907, entitled COMPRESSIBLESTAPLE CARTRIDGE ASSEMBLY; now U.S. Pat. No. 9,301,755;

U.S. patent application Ser. No. 13/097,861, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES; now U.S.Pat. No. 9,113,865;

U.S. patent application Ser. No. 13/097,869, entitled STAPLE CARTRIDGELOADING ASSEMBLY; now U.S. Pat. No. 8,857,694;

U.S. patent application Ser. No. 13/097,917, entitled COMPRESSIBLESTAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS; now U.S. Pat. No.8,777,004;

U.S. patent application Ser. No. 13/097,873, entitled STAPLE CARTRIDGECOMPRISING A RELEASABLE PORTION; now U.S. Pat. No. 8,740,038;

U.S. patent application Ser. No. 13/097,938, entitled STAPLE CARTRIDGECOMPRISING COMPRESSIBLE DISTORTION RESISTANT COMPONENTS; now U.S. Pat.No. 9,016,542;

U.S. patent application Ser. No. 13/097,924, entitled STAPLE CARTRIDGECOMPRISING A TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,168,038;

U.S. patent application Ser. No. 13/242,029, entitled SURGICAL STAPLERWITH FLOATING ANVIL; now U.S. Pat. No. 8,893,949;

U.S. patent application Ser. No. 13/242,066, entitled CURVED ENDEFFECTOR FOR A STAPLING INSTRUMENT; now U.S. Patent ApplicationPublication No. 2012/0080498;

U.S. patent application Ser. No. 13/242,086, entitled STAPLE CARTRIDGEINCLUDING COLLAPSIBLE DECK; now U.S. Pat. No. 9,055,941;

U.S. patent application Ser. No. 13/241,912, entitled STAPLE CARTRIDGEINCLUDING COLLAPSIBLE DECK ARRANGEMENT; now U.S. Pat. No. 9,050,084

U.S. patent application Ser. No. 13/241,922, entitled SURGICAL STAPLERWITH STATIONARY STAPLE DRIVERS; now U.S. Pat. No. 9,216,019;

U.S. patent application Ser. No. 13/241,637, entitled SURGICALINSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING MULTIPLE ACTUATIONMOTIONS; now U.S. Pat. No. 8,789,741;

U.S. patent application Ser. No. 13/241,629, entitled SURGICALINSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR; now U.S. PatentApplication Publication No. 2012/0074200;

U.S. patent application Ser. No. 13/433,096, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING A PLURALITY OF CAPSULES; now U.S. Pat. No.9,301,752;

U.S. patent application Ser. No. 13/433,103, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING A PLURALITY OF LAYERS; now U.S. Pat. No.9,433,419;

U.S. patent application Ser. No. 13/433,098, entitled EXPANDABLE TISSUETHICKNESS COMPENSATOR; now U.S. Pat. No. 9,301,753;

U.S. patent application Ser. No. 13/433,102, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING A RESERVOIR; now U.S. Pat. No. 9,232,941;

U.S. patent application Ser. No. 13/433,114, entitled RETAINER ASSEMBLYINCLUDING A TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,386,988;

U.S. patent application Ser. No. 13/433,136, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING AT LEAST ONE MEDICAMENT; now U.S. PatentApplication Publication No. 2012/0241492;

U.S. patent application Ser. No. 13/433,141, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING CONTROLLED RELEASE AND EXPANSION; now U.S. PatentApplication Publication No. 2012/0241493;

U.S. patent application Ser. No. 13/433,144, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING FIBERS TO PRODUCE A RESILIENT LOAD; now U.S. Pat.No. 9,277,919;

U.S. patent application Ser. No. 13/433,148, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING STRUCTURE TO PRODUCE A RESILIENT LOAD; now U.S.Pat. No. 9,220,500;

U.S. patent application Ser. No. 13/433,155, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING RESILIENT MEMBERS; now U.S. Pat. No. 9,480,476;

U.S. patent application Ser. No. 13/433,163, entitled METHODS FORFORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS FOR SURGICAL STAPLERS;now U.S. Patent Application Publication No. 2012/0248169;

U.S. patent application Ser. No. 13/433,167, entitled TISSUE THICKNESSCOMPENSATORS; now U.S. Pat. No. 9,220,501;

U.S. patent application Ser. No. 13/433,175, entitled LAYERED TISSUETHICKNESS COMPENSATOR; now U.S. Pat. No. 9,332,974;

U.S. patent application Ser. No. 13/433,179, entitled TISSUE THICKNESSCOMPENSATORS FOR CIRCULAR SURGICAL STAPLERS; now U.S. Pat. No.9,364,233;

U.S. patent application Ser. No. 13/763,028, entitled ADHESIVE FILMLAMINATE; now U.S. Pat. No. 9,282,962;

U.S. patent application Ser. No. 13/433,115, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING CAPSULES DEFINING A LOW PRESSURE ENVIRONMENT; nowU.S. Pat. No. 9,204,880;

U.S. patent application Ser. No. 13/433,118, entitled TISSUE THICKNESSCOMPENSATOR COMPRISED OF A PLURALITY OF MATERIALS; now U.S. Pat. No.9,414,838;

U.S. patent application Ser. No. 13/433,135, entitled MOVABLE MEMBER FORUSE WITH A TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No. 9,517,063;

U.S. patent application Ser. No. 13/433,140, entitled TISSUE THICKNESSCOMPENSATOR AND METHOD FOR MAKING THE SAME; now U.S. Pat. No. 9,241,714;

U.S. patent application Ser. No. 13/433,129, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING A PLURALITY OF MEDICAMENTS; now U.S. Pat. No.9,211,120;

U.S. patent application Ser. No. 11/216,562, entitled STAPLE CARTRIDGESFOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S.Pat. No. 7,669,746;

U.S. patent application Ser. No. 11/714,049, entitled SURGICAL STAPLINGDEVICE WITH ANVIL HAVING STAPLE FORMING POCKETS OF VARYING DEPTHS, nowU.S. Patent Application Publication No. 2007/0194082;

U.S. patent application Ser. No. 11/711,979, entitled SURGICAL STAPLINGDEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S.Pat. No. 8,317,070;

U.S. patent application Ser. No. 11/711,975, entitled SURGICAL STAPLINGDEVICE WITH STAPLE DRIVERS OF DIFFERENT HEIGHT, now U.S. PatentApplication Publication No. 2007/0194079;

U.S. patent application Ser. No. 11/711,977, entitled SURGICAL STAPLINGDEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES,now U.S. Pat. No. 7,673,781;

U.S. patent application Ser. No. 11/712,315, entitled SURGICAL STAPLINGDEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLEDRIVERS, now U.S. Pat. No. 7,500,979;

U.S. patent application Ser. No. 12/038,939, entitled STAPLE CARTRIDGESFOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S.Pat. No. 7,934,630;

U.S. patent application Ser. No. 13/020,263, entitled SURGICAL STAPLINGSYSTEMS THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S.Pat. No. 8,636,187;

U.S. patent application Ser. No. 13/118,278, entitledROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE FORMEDSTAPLES HAVING DIFFERENT LENGTHS, now U.S. Pat. No. 9,237,891;

U.S. patent application Ser. No. 13/369,629, entitledROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS, now U.S. Pat.No. 8,800,838;

U.S. patent application Ser. No. 12/695,359, entitled SURGICAL STAPLINGDEVICES FOR FORMING STAPLES WITH DIFFERENT FORMED HEIGHTS, now U.S. Pat.No. 8,464,923;

U.S. patent application Ser. No. 13/072,923, entitled STAPLE CARTRIDGESFOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S.Pat. No. 8,567,656;

U.S. patent application Ser. No. 13/766,325, entitled LAYER OF MATERIALFOR A SURGICAL END EFFECTOR; now U.S. Patent Application Publication No.2013/0256380;

U.S. patent application Ser. No. 13/763,078, entitled ANVIL LAYERATTACHED TO A PROXIMAL END OF AN END EFFECTOR; now U.S. PatentApplication Publication No. 2013/0256383;

U.S. patent application Ser. No. 13/763,094, entitled LAYER COMPRISINGDEPLOYABLE ATTACHMENT MEMBERS; now U.S. Pat. No. 9,788,834;

U.S. patent application Ser. No. 13/763,106, entitled END EFFECTORCOMPRISING A DISTAL TISSUE ABUTMENT MEMBER; now U.S. Pat. No. 9,592,050;

U.S. patent application Ser. No. 13/433,147, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING CHANNELS; now U.S. Pat. No. 9,351,730;

U.S. patent application Ser. No. 13/763,112, entitled SURGICAL STAPLINGCARTRIDGE WITH LAYER RETENTION FEATURES; now U.S. Patent ApplicationPublication No. 2013/0256379;

U.S. patent application Ser. No. 13/763,035, entitled ACTUATOR FORRELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE; nowU.S. Patent Application Publication No. 2013/0214030;

U.S. patent application Ser. No. 13/763,042, entitled RELEASABLE TISSUETHICKNESS COMPENSATOR AND FASTENER CARTRIDGE HAVING THE SAME; now U.S.Patent Application Publication No. 2013/0221063;

U.S. patent application Ser. No. 13/763,048, entitled FASTENER CARTRIDGECOMPRISING A RELEASABLE TISSUE THICKNESS COMPENSATOR; now U.S. Pat. No.9,700,317;

U.S. patent application Ser. No. 13/763,054, entitled FASTENER CARTRIDGECOMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESSCOMPENSATOR; now U.S. Pat. No. 9,272,406;

U.S. patent application Ser. No. 13/763,065, entitled FASTENER CARTRIDGECOMPRISING A RELEASABLY ATTACHED TISSUE THICKNESS COMPENSATOR; now U.S.Pat. No. 9,566,061;

U.S. patent application Ser. No. 13/763,021, entitled STAPLE CARTRIDGECOMPRISING A RELEASABLE COVER; now U.S. Pat. No. 9,386,984;

U.S. patent application Ser. No. 13/763,078, entitled ANVIL LAYERATTACHED TO A PROXIMAL END OF AN END EFFECTOR; now U.S. PatentApplication Publication No. 2013/0256383;

U.S. patent application Ser. No. 13/763,095, entitled LAYER ARRANGEMENTSFOR SURGICAL STAPLE CARTRIDGES; now U.S. Pat. No. 9,770,245;

U.S. patent application Ser. No. 13/763,147, entitled IMPLANTABLEARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES; now U.S. Patent ApplicationPublication No. 2013/0153636;

U.S. patent application Ser. No. 13/763,192, entitled MULTIPLE THICKNESSIMPLANTABLE LAYERS FOR SURGICAL STAPLING DEVICES; now U.S. Pat. No.9,615,826;

U.S. patent application Ser. No. 13/763,161, entitled RELEASABLE LAYEROF MATERIAL AND SURGICAL END EFFECTOR HAVING THE SAME; now U.S. PatentApplication Publication No. 2013/0153641;

U.S. patent application Ser. No. 13/763,177, entitled ACTUATOR FORRELEASING A LAYER OF MATERIAL FROM A SURGICAL END EFFECTOR; now U.S.Pat. No. 9,585,657;

U.S. patent application Ser. No. 13/763,037, entitled STAPLE CARTRIDGECOMPRISING A COMPRESSIBLE PORTION; now U.S. Patent ApplicationPublication No. 2013/0224857;

U.S. patent application Ser. No. 13/433,126, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING TISSUE INGROWTH FEATURES; now U.S. Pat. No.9,320,523;

U.S. patent application Ser. No. 13/433,132, entitled DEVICES ANDMETHODS FOR ATTACHING TISSUE THICKNESS COMPENSATING MATERIALS TOSURGICAL STAPLING INSTRUMENTS; now U.S. Patent Application PublicationNo. 2013/0256373;

U.S. patent application Ser. No. 13/851,703, entitled FASTENER CARTRIDGECOMPRISING A TISSUE THICKNESS COMPENSATOR INCLUDING OPENINGS THEREIN;now U.S. Pat. No. 9,572,577;

U.S. patent application Ser. No. 13/851,676, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING A CUTTING MEMBER PATH; now U.S. PatentApplication Publication No. 2014/0291379;

U.S. patent application Ser. No. 13/851,693, entitled FASTENER CARTRIDGEASSEMBLIES; now U.S. Pat. No. 9,332,984; and

U.S. patent application Ser. No. 13/851,684, entitled FASTENER CARTRIDGECOMPRISING A TISSUE THICKNESS COMPENSATOR AND A GAP SETTING ELEMENT; nowU.S. Pat. No. 9,795,384.

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those of ordinary skill in the art will understand that thedevices and methods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the various embodiments of the present invention is definedsolely by the claims. The features illustrated or described inconnection with one exemplary embodiment may be combined with thefeatures of other embodiments. Such modifications and variations areintended to be included within the scope of the present invention.

Reference throughout the specification to “various embodiments,” “someembodiments,” “one embodiment,” or “an embodiment”, or the like, meansthat a particular feature, structure, or characteristic described inconnection with the embodiment is included in at least one embodiment.Thus, appearances of the phrases “in various embodiments,” “in someembodiments,” “in one embodiment”, or “in an embodiment”, or the like,in places throughout the specification are not necessarily all referringto the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments. Thus, the particular features, structures, orcharacteristics illustrated or described in connection with oneembodiment may be combined, in whole or in part, with the featuresstructures, or characteristics of one or more other embodiments withoutlimitation. Such modifications and variations are intended to beincluded within the scope of the present invention.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the surgical instrument. The term “proximal”referring to the portion closest to the clinician and the term “distal”referring to the portion located away from the clinician. It will befurther appreciated that, for convenience and clarity, spatial termssuch as “vertical”, “horizontal”, “up”, and “down” may be used hereinwith respect to the drawings. However, surgical instruments are used inmany orientations and positions, and these terms are not intended to belimiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, theperson of ordinary skill in the art will readily appreciate that thevarious methods and devices disclosed herein can be used in numeroussurgical procedures and applications including, for example, inconnection with open surgical procedures. As the present DetailedDescription proceeds, those of ordinary skill in the art will furtherappreciate that the various instruments disclosed herein can be insertedinto a body in any way, such as through a natural orifice, through anincision or puncture hole formed in tissue, etc. The working portions orend effector portions of the instruments can be inserted directly into apatient's body or can be inserted through an access device that has aworking channel through which the end effector and elongated shaft of asurgical instrument can be advanced.

Turning to the drawings wherein like numerals denote like componentsthroughout the several views, FIG. 1 depicts a shaftless surgical system2. The shaftless surgical system 2 comprises a trocar 4 and a shaftlessend effector 6. In use, the trocar 4 is inserted through one or moreopenings formed in a patient, such as, for example, a natural orificeopening, a translumenal opening, a surgical opening, and/or any othersuitable opening. In some embodiments, the trocar 4 comprises anendoscopic and/or laparoscopic instrument. The end effector 6 may belocated within the trocar 4 when the trocar 4 is introduced to asurgical site. In certain embodiments, the end effector 6 may beinserted into the trocar 4 after the trocar 4 has been introduced to thesurgical site. In some embodiments, an actuator is introduced into theproximal end of the trocar 4 to push the end effector 6 out of thetrocar 4. In other embodiments, an actuator is introduced into thedistal end of the trocar to pull the end effector 6 out of the trocar 4.

In various embodiments, the shaftless end effector 6 comprises a firstjaw member 8 a and a second jaw member 8 b. The first jaw member 8 acomprises an anvil 10 having a staple-forming surface. Thestaple-forming surface can comprise a plurality of staple formingpockets therein. The first jaw member 8 a is moveably coupled to asecond jaw member 8 b. The second jaw member 8 b comprises alongitudinal channel 42 configured to receive a staple cartridge 12. Thestaple cartridge 12 comprises a plurality of staples 14 disposedtherein. A pin 15 extending from first jaw member 8 a is received withina slot 16 formed on the second jaw member 8 b. The pin 15 and the slot16 are configured to allow pivoting (rotation) and/or vertical movement(translation) of the first jaw member 8 a with respect to the second jawmember 8 b. In various embodiments, the second jaw member 8 b may befabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainlesssteel, titanium, etc., and may be formed with spaced side walls. Thefirst jaw member 8 a may be fabricated from, for example, 300 & 400Series, 17-4 & 17-7 stainless steel, titanium, etc., and have a stapleforming undersurface comprising a plurality of staple forming pocketsformed therein.

Various forms of staple cartridges may be employed with the variousembodiments of the end effector 6 disclosed herein. In some embodiments,an implantable staple cartridge 12 may be used. In at least oneembodiment, the staple cartridge 12 comprises a body portion 18 thatcomprises a compressible material such as, for example, a hemostaticmaterial, oxidized regenerated cellulose (“ORC”) and/or a bioabsorbablefoam in which lines of unformed metal staples 14, for example, aresupported. In at least some embodiments, in order to prevent thealignment of the staples 14 within the cartridge body 18 from beingaffected and/or the hemostatic material from being activated during theintroduction and positioning of the end effector 6 within a surgicalsite, the entire staple cartridge 12 may be coated or wrapped in abiodegradable film, such as, for example, a polydioxanone film soldunder the trademark PDS®, a Polyglycerol sebecate (PGS) film, abiodegradable film formed from PGA (Polyglycolic acid, marketed underthe trademark Vicryl), PCL (Polycaprolactone), PLA or PLLA (Polylacticacid), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold underthe trademark Monocryl), and/or a composite of PGA, PCL, PLA, and/or PDSthat would be impermeable until ruptured. The body portion 18 of thestaple cartridge 12 is sized to be supported within the longitudinalchannel 42 of the lower jaw member 8 b such that each staple 14 isaligned with a corresponding staple forming pocket in the anvil 10 whenthe anvil 10 is driven into forming contact with the staple cartridge12. In various instances, the staple cartridge 12 can be removable fromthe end effector 6 and, in other instances, the staple cartridge 12 maynot be removable from the end effector 6.

In use, the end effector 6 is positioned adjacent to target tissue. Theend effector 6 is manipulated to capture or clamp the target tissuebetween the anvil 10 and the staple cartridge 12. Referring to FIG. 7,the anvil 10 is illustrated in an open position. The anvil 10 can berotated downwardly toward the tissue T into a closed, or clamped,position, as illustrated in FIG. 8. A closure system configured to movethe anvil 10 into a closed position is discussed in greater detailfurther below. The staples 14 are formed by moving the anvil 10vertically, or downwardly, toward the staple cartridge 12 whilemaintaining the anvil 10 in a parallel, or an at least substantiallyparallel, orientation with respect to the staple cartridge 12 in orderto bring the staple forming surface and the staple forming pockets ofthe anvil 10 into contact with the staple cartridge 12, as illustratedin FIG. 9. As the anvil 10 continues to move into the staple cartridge12, referring now to FIG. 10, the legs of the staples 14 contact acorresponding staple forming pocket in the anvil 10 which serves to bendthe staple 14 legs and form the staples 14 into a “B shape”, forexample. Further movement of the anvil 10 towards the staple cartridge12 will further compress and form the staples 14 to a desired finalformed height.

Further to the above, the end effector 6 can comprise a closure systemconfigured to close the anvil 10. FIG. 1 illustrates a closure system 20comprising a proximal end slide 22 a and a distal end slide 22 b. Theproximal end slide 22 a and the distal end slide 22 b can each comprisea cavity 24 for receiving a portion of the first jaw member 8 a and aportion of the second jaw member 8 b therein. The proximal slide 22 acomprises a slide portion 26 a extending longitudinally therefrom andthe distal slide 22 b comprise a slide portion 26 b extendinglongitudinally therefrom. The slide portions 26 a, 26 b are slideablyreceivable within a longitudinal aperture 28 formed in the lower jawmember 8 b. FIGS. 2-6 illustrate various cross-sectional views of theshaftless surgical system 2 illustrated in FIG. 1. FIG. 2 illustrates across-sectional view of the shaftless surgical system 2 showing thetrocar 4 and the distal slide 22 b. FIG. 3 illustrates a cross-sectionalview of the shaftless surgical system 2 showing the distal slide 22 band the cavity 24 defined therein for receiving a distal end of thefirst jaw member 8 a and a distal end of the second jaw member 8 b. FIG.4 illustrates a cross-sectional view of the shaftless surgical system 2showing the first jaw member 8 a comprising a recess configured toreceive a portion of the distal slide 22 b, as described in greaterdetail further below. In some embodiments, the recess comprises aplurality of retention and/or depth gauge features 38, which will alsobe described in greater detail further below. The slide portion 26 b ofthe distal slide 22 b is further illustrated in FIG. 4 and is positionedwithin the longitudinal aperture 28 defined in the second jaw member 8b. FIG. 5 illustrates a cross-sectional view of the shaftless surgicalsystem 2 showing the first jaw member 8 a and the second jaw member 8 bat a location which is intermediate the proximal slide 22 a and thedistal slide 22 b. FIG. 6 illustrates a cross-sectional view of theshaftless surgical system 2 showing the pin 15 and slot 16 coupling thefirst jaw member 8 a and the second jaw member 8 b. FIG. 6 furtherillustrates the proximal slide 22 a and the proximal slide portion 26 a.The proximal slide portion 26 a is slideably received within thelongitudinal aperture 28 defined in the second jaw 8 b. In variousinstances, the slide portion 26 a and/or the slide portion 26 b cansupport the second jaw 8 b as the first jaw 8 a is pushed toward thesecond jaw 8 b to deform the staples as discussed above.

FIG. 7 illustrates the end effector 6 in a deployed position, i.e., aposition within a patient. As outlined above, the end effector 6 can bedeployed from the trocar 4, for example, by inserting a push rod intothe trocar 4 in order to push the shaftless end effector 6 out of thetrocar 4. When deployed from the trocar 4, the first jaw member 8 a andthe second jaw member 8 b can assume an open position and/or can bemanipulated to assume an open position. In at least one embodiment, theanvil 10 is biased into an open position by an anvil spring (not shown)and/or another biasing arrangement. The anvil spring biases the firstjaw member 8 a and the second jaw member 8 b into an open position suchthat, when the shaftless end effector 6 is deployed from the trocar 4,the shaftless end effector 6 assumes the open position illustrated inFIG. 7.

FIGS. 7-10 illustrate a tissue clamping and staple-forming process. InFIG. 7, a target tissue “T” is positioned between the anvil 10 and thestaple cartridge 12. The anvil 10 is pivoted with respect to the lowerjaw member 8 b to an initial clamping, or partially-closed, positionillustrated in FIG. 8. In some embodiments, a grasper and/or anotherinstrument can be inserted through the trocar 4, and/or through anothertrocar, for example, to push the proximal slide 22 a and the distalslide 22 b toward one another, i.e., toward the center of the endeffector 6 is used to transition the anvil 10 to a partially closedposition. In various instances, the proximal slide 22 a can beconfigured to contact the first jaw 8 a and move the first jaw 8 a fromits open position to a partially closed position. Once the first jaw 8 ahas reached a partially closed position, the distal slide 22 b can bemoved into contact with the first jaw 8 a. Thereafter, the slides 22 aand 22 b can be pushed toward one another at the same time and/orsequentially in order to compress the anvil 10 onto the target tissue“T” and clamp the target tissue “T” between the anvil 10 and the staplecartridge 12. FIG. 9 illustrates the initial staple formation whereinthe anvil 10 has just come into contact with the staple cartridge 12.FIG. 10 illustrates the staples 14 in their final formed position.

Further to the above, the end slides 22 a, 22 b can each define a cavity24 for receiving the first jaw member 8 a and the second jaw member 8 btherein. The inner surface of the cavity 24 defined in each of the endslides 22 a, 22 b can comprise a cam surface, such as cam surface 30,for example. In various instances, each cam surface 30 can comprise anangled surface, for example. In certain instances, the angled surfacescan be configured to engage angled surfaces on the first jaw 8 a. Forexample, the proximal end of the first jaw 8 a can comprise a followersurface 32 which can be engaged by the cam surface 30 defined on theproximal end slide 22 a as the proximal end slide 22 a is moved distallytoward the distal end slide 22 b. Similarly, the distal end of the firstjaw 8 a can comprise a follower surface 32 which can be engaged by thecam surface 30 defined on the distal end slide 22 b as the distal endslide 22 b is moved proximally toward the distal end slide 22 a. Invarious instances, the angle of the cam surface 30 can match an angle ofthe follower surface 32 while, in other instances, the angle of the camsurface 30 can be different than an angle of the follower surface 32. Incertain instances, one set of surfaces 30, 32, such as the proximal setof surfaces, may be defined by a first matching angle and the other setof surfaces 30, 32, such as the distal set of surfaces, may be definedby a second matching angle which is different than the first matchingangle. In various embodiments, the configurations of the cam surfaces 30and the follower surfaces 32 can be selected to allow the anvil 10 tomaintain an at least substantially parallel orientation with respect tothe staple cartridge 12 in order to form of all staple 14simultaneously.

In some embodiments, the end effector 6 can comprise at least one gaugeconfigured to indicate the formed height of the staples. In variousinstances, the proximal end of the end effector 6 can include a formedheight gauge 31 and/or the distal end of the end effector 6 can includea formed height gauge 31, for example. In certain instances, theproximal end slide 22 a and/or the distal end slide 22 b comprise agauge element configured to indicate the formed height of the staples14. In various instances, a gauge can include a series or an array ofdemarcations defined on the distal end of the second jaw 8 a and, inaddition, a gauge element extending from the distal end slide 22 b. Inat least one such embodiment, the gauge element can comprise an arm 34including a head 36 and the array of demarcations can comprise aplurality of teeth 38 wherein the position of the head 36 relative tothe teeth 38 can indicate the distance in which the anvil 10 has beenpushed downwardly. Similarly, a gauge can include a series or an arrayof demarcations defined on the proximal end of the second jaw 8 a and agauge element extending from the proximal end slide 22 a. Also similarto the above, the gauge element can comprise an arm 34 including a head36 and the array of demarcations can comprise a plurality of teeth 38wherein the position of the head 36 relative to the teeth 38 canindicate the distance in which the anvil 10 has been pushed downwardly.Referring again to FIG. 9, the anvil 10 has been positioned against thestaple cartridge 12 and, in such a position, the head 36 of the gaugeelement extending from the proximal end slide 22 a has slid over theouter-most tooth 38 in the proximal array of teeth 38 and the head 36 ofthe gauge element extending from the distal end slide 22 b has slid overthe outer-most tooth 38 in the distal array of teeth 38. This relativepositioning of the gauge heads 36 with respect to the arrays of teeth 38can indicate to a clinician that the staples 14 have not yet beendeformed by the anvil 10. As the proximal end slide 22 a is movedinwardly, the proximal end slide 22 a can drive the proximal end of thefirst jaw 8 a downwardly and the head 36 extending therefrom can slideover one or more additional teeth 38. Similarly, as the distal end slide22 b is moved inwardly, the distal end slide 22 b can drive the distalend of the first jaw 8 a downwardly and the head 36 extending therefromcan slide over one or more additional teeth 38. When the heads 36 haveslid over all of the teeth 38, as illustrated in FIG. 10, the cliniciancan assume that the staples 14 have been fully formed.

Various embodiments disclosed herein employ a compressible staplecartridge 12 that supports staples in a substantially stationaryposition for forming contact by the anvil 10. In various embodiments,the anvil 10 is driven into the unformed staples 14 wherein, in at leastone such embodiment, the degree of staple formation attained isdependent upon how far the anvil 10 is driven into the staples. Such anarrangement provides the surgeon with the ability to adjust the amountof forming or firing pressure applied to the staples and thereby altersthe final formed height of the staples.

Further to the above, the gauge elements extending from the end slides22 a and 22 b can comprise retention members which can be configured tohold and/or lock the end slides 22 a and 22 b in position. In variousinstances, the heads 36 of the gauge elements and/or the teeth 38 caninclude lock shoulders configured to, one, permit the end slides 22 aand 22 b to be moved inwardly and, two, resist the outward movement ofthe end slides 22 a and 22 b. In various embodiments, the gauges cancomprise ratchet systems permitting movement in one direction butprohibiting movement in the opposite direction. In order to overcome thelocking effects of the gauge elements, the heads 36 of the gaugeelements can be raised and/or deflected away from the arrays of teeth38. Once the gauge elements have been disengaged from the first jaw 8 a,the end slides 22 a, 22 b can be moved outwardly to permit the first jaw8 a to open. As discussed above, the first jaw 8 a can be moved into itsopen position by a spring and/or can be pulled open by a grasper, suchas grasper 154 (FIG. 11), for example

Previous end effectors extended from a shaft of a surgical instrumentwherein one or more drive members extending through the shaft wereutilized to operate the end effector. As the reader will appreciate, theend effector 6 is not attached to the shaft of a surgical instrumentand, thus, is shaftless. In various instances, as discussed above, agrasper, for example, can be utilized to push the end slides 22 a, 22 bof the end effector 6 inwardly. The grasper can be configured to movethe end slides 22 a, 22 b one at a time or simultaneously. In variousinstances, a closure mechanism, such as, for example, a grasper (notshown) is coupled to the shaftless closure system 20. In certaininstances, the grasper is opened and the shaftless end effector 6 ispositioned between two arms of the grasper. The grasper is transitionedfrom an open position to a closed position to cause the proximal slide22 a and the distal slide 22 b to slide towards a middle point of theshaftless end effector 6. The cam surfaces 30 of the proximal slide 22 aand the distal slide 22 b interface with the follower surfaces 32defined on the anvil 10, causing the anvil 10 to compress towards thestaple cartridge 12. As discussed above, the anvil 10 can compress thetarget tissue “T” and deploy the staples 14 into the target tissue “T.”Once the staples 14 have been formed and fastened to the target tissue“T”, further to the above, the surgeon can open the grasper and removeit from the surgical site. The anvil 10 can then be opened to releasethe stapled tissue “T” and the end effector 6 can be removed from thesurgical site. As the reader will appreciate, the staple body 18 crushedand captured by the staples 14 can remain behind, or implanted. Theremaining “crushed” staple body 18 can act as a hemostatic material, astaple line reinforcement, and/or a compensator for variations in tissuethickness. As used herein the term “implantable” means that, in additionto the staples 14, at least a portion of the staple cartridge body 18captured by the staples 14 will also remain in the patient. Theimplanted cartridge body 18 may or may not eventually be absorbed by thepatient's body. Although the various embodiments are described hereinwith reference to implantable staple cartridges, one skilled in the artwill recognize that non-implantable cartridges, i.e., cartridges inwhich the staple cartridge remains positioned within the shaftless endeffector after it is fired, may also be used. In various instances, suchsurgical stapling arrangements can employ staple driving elements whichcan lift the staples towards the anvil.

Although the shaftless end effector 6 is illustrated comprising aproximal slide 22 a and a distal slide 22 b, the reader will recognizethat either the proximal slide 22 a and/or the distal slide 22 b may beomitted. In some embodiments, after the staples have been formed orfired into the target tissue, the shaftless end effector 6 may bereleased, for example, by actuating a release mechanism. The releasemechanism can release the proximal slide 22 a and/or the distal slide 22b causing the anvil 10 to assume an open position.

In certain embodiments, the shaftless end effector 6 may be solely usedas a tissue stapling device. However, in various embodiments, theshaftless end effector 6 comprises a cutting member 40. The cuttingmember 40 is configured to cut the target tissue “T” along alongitudinal axis of the end effector 6. In some embodiments, thecutting member 40 comprises a fixed blade. In at least one embodiment,the lower jaw member 8 b comprises a sharpened cutting member 40configured to interface with a mating member formed on the anvil 10.When the anvil 10 is compressed towards the staple cartridge 12, theanvil 10 pushes the tissue T against the cutting member 40 which thencuts the target tissue T. In other embodiments, the cutting member cancomprise a slideable cutting member deployable from an un-actuatedposition adjacent to the proximal end of the shaftless end effector 6 toan actuated position adjacent the distal end, for example. In at leastone such instance, the cutting member can be configured to slideablyextend through a slot in the anvil 10 and a centrally disposed slot inthe staple cartridge 12. A slideable cutting member may be deployed, forexample, by a rotatable shaft, which is described in greater detailfurther below. In some embodiments, the slideable cutting membercomprises a sled for deploying the staples 14.

FIG. 11 illustrates an embodiment of a shaftless end effector 106. Theshaftless end effector 106 is similar to the shaftless end effector 6illustrated in FIGS. 1-10. The shaftless end effector 106 comprises afirst jaw member 108 a and a second jaw member 108 b. The first jawmember 108 a comprises an anvil 110 having a plurality of staple formingpockets therein. The second jaw member 108 b comprises a channel 142configured to receive a staple cartridge, such as, for example, animplantable staple cartridge. A shaftless closure system 120 isconfigured to transition the end effector 106 from an open position to aclosed position and to deploy the staples of a staple cartridge locatedwithin the channel 142. The shaftless closure system comprises aproximal slide 122 a and a distal slide 122 b. The proximal slide 122 aand the distal slide 122 b are configured to slideably interface withthe first jaw member 108 a and the second jaw member 108 b to drive theanvil 110 into contact with, and form the staples within, a staplecartridge. The proximal slide 122 a comprises an angled grasping portionwhich extends in a direction which is transverse to a longitudinal axisof the end effector 106. In various instances, the angled graspingportion can comprise a ski tip 150. The ski tip 150 can be configured tofacilitate the insertion of the end effector 106 relative to orunderneath certain tissue. The ski tip 150 comprises a grasping section152 configured to interface with a grasper 154. The grasper 154 maycomprise any suitable grasper, such as, for example, a grasping deviceconfigured for insertion through the trocar 4. The ski tip 150 canfacilitate the placement of the shaftless end effector 106 under avessel or target tissue, for example. In some embodiments, afterpositioning the shaftless end effector 106 under the target tissue, thegrasper 154 is used to transition the shaftless end effector 106 fromthe open position illustrated in FIG. 11 to a partially closed position.The grasper 154 and/or an additional mechanical actuator is interfacedwith the shaftless closure system 120 to transition the shaftless endeffector 106 from a partially-closed position to a fired position bypushing the slides 122 a and 122 b toward one another. Although the skitip 150 is illustrated as coupled to the proximal slide 122 a, a ski tip150 may extend from the distal slide 122 b.

FIGS. 12-13 illustrate one embodiment of a shaftless end effector 206.The shaftless end effector 206 comprises a first jaw member 208 a and asecond jaw member 208 b. The first jaw member 208 a comprises an anvil210 having a plurality of staple forming pockets therein. The second jawmember 208 b comprises a longitudinal channel 242 configured to receivea staple cartridge, such as, for example, an implantable staplecartridge. The first jaw member 208 a and the second jaw member 208 bare coupled by a pin 215 and a slot 216. The pin 215 enables pivotal andvertical movement of the anvil 210 with respect to the second jaw member208 b. A shaftless closure system 220 is configured to transition theshaftless end effector 206 from an open position to a closed position.The shaftless closure system comprises a proximal slide 222 a and adistal slide 222 b. The proximal slide 222 a and the distal slide 222 beach comprise a cam formed thereon configured to interface with a bevelformed on the anvil 210. The interface between the cams of the proximalslide 222 a and the distal slide 222 b and the bevels of the first jaw208 a can drive the anvil 210 into contact with the staple cartridgewhile maintaining the anvil 210 in a substantially parallelconfiguration with respect to the second jaw member 208 b. The proximalslide 222 a can comprise a coupling mechanism 258 configured to couple adetachable guide tether 256 to the shaftless end effector 206. In someembodiments, the guide tether 256 comprises an angled plane 260. Theangled plane 260 extends at an angle with respect to the longitudinalplane of the second jaw member 208 b. The angled plane 260 may comprise,for example, a ski tip. The guide tether 256 may be manipulated by asurgeon to position the shaftless end effector 206 at a treatment site.For example, in one embodiment, the detachable guide tether 256 extendsproximally through a trocar and out of the patient and may be pulled bythe surgeon to position the shaftless end effector 206. Once theshaftless end effector 206 has been positioned, the guide tether 256 canbe detached from the shaftless end effector 206 as illustrated in FIG.13. Although the guide tether 256 is illustrated attached to theproximal slide 222 a, the reader will recognize that a couplingmechanism 258 may be formed on the distal slide 222 b and the guidetether 256 may be coupled to the distal slide 222 b. In any event, theguide tether 256 may be used as an actuator to rotate the anvil 210 intoa partially closed position by pushing the slide 222 a and/or the slide222 b inwardly.

FIG. 14 illustrates an embodiment of a shaftless end effector 306comprising a tearable guide tether 356. The shaftless end effector 306comprises a first jaw member 308 a and a second jaw member 308 b. Thefirst jaw member 308 a comprises an anvil 310 having a plurality ofstaple forming pockets therein. The second jaw member 308 b comprises alongitudinal channel 342 configured to receive a staple cartridge, suchas, for example, an implantable staple cartridge. The first jaw member308 a and the second jaw member 308 b are coupled by a pin 315 and aslot 316. The pin 315 enables pivotal and vertical movement of the anvil310 with respect to the second jaw member 308 b. A shaftless closuresystem 320 is configured to transition the shaftless end effector 306from an open position to a closed position. The shaftless closure systemcomprises a proximal slide 322 a and a distal slide 322 b. The proximalslide 322 a and the distal slide 322 b each comprise a cam formedthereon and configured to interface with bevels formed on the anvil 310.The interface between the cams of the proximal slide 322 a and thedistal slide 322 b and the bevels on the anvil 310 drive the anvil 310into contact with the staple cartridge while maintaining the anvil 310in a substantially parallel configuration with respect to the second jawmember 308 b. The proximal slide 322 a is coupled to a guide tether 356by a tearable section 358. The guide tether 356 may extend proximallythrough a trocar 4 and may be manipulated by a surgeon to position theshaftless end effector 306 at a target site. After positioning theshaftless end effector 306, the guide tether 356 can be released fromthe shaftless end effector 306 by tearing the tearable section 358. FIG.15 illustrates the tearable section 358 of the guide tether 356 coupledto the shaftless end effector 306. FIG. 16 illustrates the tearablesection 358 after the tether 356 is separated from the shaftless endeffector 306.

FIG. 17 illustrates an embodiment of a shaftless end effector 406comprising a drive system 420. The shaftless end effector 406 comprisesa first jaw member 408 a and a second jaw member 408 b. The first jawmember 408 a comprises an anvil 410 having a plurality of staple formingpockets formed therein. The second jaw member 408 b comprises alongitudinal channel 442 configured to receive a staple cartridge 412therein. The staple cartridge 412 comprises a plurality of staples 14.The first jaw member 408 a and the second jaw member 408 b are pivotallycoupled. A pin 415 coupled to the first jaw member 408 a is slideablyretained within a slot 416 formed in the second jaw member 408 b. Thepin 415 and the slot 416 enable the anvil 410 to pivot with respect tothe second jaw member 408 b and to move vertically towards the secondjaw member 408 b.

A rotatable shaft 464 extends longitudinally through the second jawmember 408 b. The rotatable shaft 464 is operably engaged with aproximal slide 422 a and a distal slide 422 b of the drive system 420.The proximal slide 422 a and the distal slide 422 b can each comprise acam 430. One and/or both of the cams 430 are configured to engage theanvil 410, rotate the anvil 410 into a closed position, and translatethe anvil 410 downwardly toward the cartridge 412. The shaft 464comprises a proximal drive end 466 extending from the proximal slide 422a. In various instances, a rotatable input, such as rotation mechanism468, for example, can be coupled to the proximal drive end 466 to rotatethe rotatable shaft 464. The shaft 464 can further comprise a firstthreaded portion 465 a, a second threaded portion 465 b, and a thirdthreaded portion 465 c. The first threaded portion 465 a can bethreadably engaged with a threaded longitudinal aperture defined in theproximal slide 422 a. When the shaft 464 is rotated in a firstdirection, the first threaded portion 465 a can displace the proximalslide 422 a toward the distal slide 422 b. The second threaded portion465 b can be threadably engaged with a threaded longitudinal aperturedefined in the distal slide 422 b. When the shaft 464 is rotated in thefirst direction, the second threaded portion 465 b can displace thedistal slide 422 b toward the proximal slide 422 a. In order to achievesuch relative motion, in various embodiments, the first threaded portion465 a can comprise right-hand threads while the second threaded portion465 b can comprise left-hand threads, for example. When the proximalslide 422 a and the distal slide 422 b are moved toward each other, oneand/or both of the slides 422 a and 422 b can rotate the anvil 410 intoa closed position and push the anvil 410 downwardly to crush the staples14.

FIGS. 17, 19, and 21 illustrate the operation of the shaftless endeffector 406 transitioning from an open condition to a fired condition.As shown in FIG. 17, a target tissue “T” is positioned between the anvil410 and the staple cartridge 412 when the anvil 410 is in an openposition. The shaftless end effector 406 is transitioned to apartially-closed position by pivoting the anvil 410 with respect to thesecond jaw member 408 b. In some instances, the anvil 410 may be pivotedby, for example, applying a force to the anvil 410 with a grasperinserted through a trocar 4. In other instances, the anvil 410 may bemoved into an at least partially-closed position by the proximal slide422 a. In any event, the rotatable shaft 464 is rotated to cause theproximal slide 422 a and the distal slide 422 b to move longitudinallytowards a center point of the shaftless end effector 406. The shaft 464can be rotated until the proximal slide 422 a and the distal slide 422 bfully compress the anvil 410 against the cartridge 412 and configure theshaftless end effector 406 in a fired condition, as illustrated in FIG.19. In other situations, the shaft 464 can be rotated to partiallycompress the cartridge 412 and partially form the staples 14. In variousinstances, the proximal slide 422 a and the distal slide 422 b cancontact the first jaw 408 a at the same time or at different times. Inat least one instance, the proximal slide 422 a can contact the firstjaw 408 a before the distal slide 422 b contacts the first jaw 408 a.

Referring again to FIG. 17, the end effector 406 can further include acutting member, such as cutting member 440, for example. When the endeffector 406 is in an open condition, as illustrated in FIG. 17, thecutting member 440 can be positioned in a proximal, unadvanced position.As illustrated in FIG. 18, the cutting member 440 can include a threadedlongitudinal aperture 470 defined therein wherein the shaft 464 canextend through the longitudinal aperture 470. In the proximal,unadvanced position of the cutting member 440, the threaded aperture 470may not be threadably engaged with the shaft 464. More particularly, theshaft 464 can include an unthreaded portion 467 extending between thefirst threaded portion 465 a and the third threaded portion 465 c and,when the cutting member 440 is in its proximal, unadvanced position, theunthreaded portion 467 of the shaft 464 can be positioned within thethreaded aperture 470. In such circumstances, the shaft 464 may notdirectly move the cutting member 440 when the shaft 464 is rotated;however, referring to FIGS. 17 and 19, the cutting member 440 can beadvanced distally, at least initially, by the proximal slide 422 a.Stated another way, the proximal slide 422 a can push the cutting member440 toward the cartridge 412 when the proximal slide 422 a is movedinwardly by the rotation of the shaft 464, as discussed above. Invarious instances, the proximal slide 422 a can move the cutting member440 into a pre-stage position, i.e., a position where the cutting member440 is about to transect, but has not yet transected, the cartridge 412and/or the tissue T captured between the cartridge 412 and the anvil410. In various instances, the proximal slide 422 a can move the cuttingmember 440 into its pre-stage position when the proximal slide 422 a hasreached its closed position, as illustrated in FIG. 19. In otherinstances, the proximal slide 422 a can move the cutting member 440 intoits pre-stage position before the proximal slide 422 a has reached itsclosed position. In either event, the cutting member 440 can becomeoperably engaged with the shaft 464 when the cutting member 440 hasreached its pre-stage position. More particularly, the proximal slide422 a can push the cutting member 440 distally until the threadedaperture 470 defined in the cutting member 440 becomes threadablyengaged with the threaded position 465 c. Once the cutting member 440has been threadably engaged with the shaft 464, further rotation of theshaft 464 in the first direction can advance the cutting member 440distally, as illustrated in FIG. 21.

As outlined above, the first threaded portion 465 a can advance theproximal slide 422 a from its unactuated position (FIG. 17) to its fullyactuated position (FIG. 19). As the shaft 464 is rotated, the proximalslide 422 a will advance along the length of the first threaded portion465 a. Once the proximal slide 422 a has been moved into its fullyactuated position, the proximal slide 422 a may no longer be engagedwith the shaft 464 and further rotation of the shaft 464 in the firstdirection may not further advance the proximal slide 422 a. Statedanother way, the first threaded portion 465 a may push the proximalslide 422 a to a point where the first threaded portion 465 a is nolonger threadably engaged with the threaded aperture defined in theproximal slide 422 a and, at such point, an unthreaded portion 467 ofthe shaft 464 can be positioned within the threaded aperture. Similarly,the second threaded portion 465 b can advance the distal slide 422 bfrom its unactuated position (FIG. 17) to its fully actuated position(FIG. 19). As the shaft 464 is rotated, the distal slide 422 b willadvance along the length of the second threaded portion 465 b. Once thedistal slide 422 b has been moved into its fully actuated position, thedistal slide 422 b may no longer be engaged with the shaft 464 andfurther rotation of the shaft 464 in the first direction may not furtheradvance the distal slide 422 b. Stated another way, the second threadedportion 465 b may push the distal slide 422 b to a point where thesecond threaded portion 465 b is no longer threadably engaged with thethreaded aperture defined in the distal slide 422 b and, at such point,an unthreaded portion 467 of the shaft 464 can be positioned within thethreaded aperture 470. In various instances, the proximal slide 422 acan become disengaged from the first threaded portion 465 a at the sametime, or at least substantially the same time, that the distal slide 422b becomes disengaged from the second threaded portion 465 b. In someinstances, the proximal slide 422 a can become disengaged from the firstthreaded portion 465 a before or after the distal slide 422 b becomesdisengaged from the second threaded portion 465 b. In various instances,the proximal slide 422 a can become disengaged from the first threadedportion 465 a at the same time, or at substantially the same time, thatthe cutting member 440 becomes engaged with the third threaded portion465 c. In other instances, the proximal slide 422 a can becomedisengaged from the first threaded portion 465 a before or after thecutting member 440 becomes engaged with the third threaded portion 465c.

After the knife 440 has been sufficiently advanced by the shaft 464 toincise the tissue T and/or incise the cartridge 412, the knife 440 canbe retracted by rotating the shaft 464 in a second, or opposite,direction. In such instances, the knife 440 can travel back along thethird threaded portion 465 c until it returns to its pre-staged positionin which it is no longer threadably engaged with the third threadedportion 465 c. Similarly, the rotation of the shaft 464 in the seconddirection can return the proximal slide 422 a and the distal slide 422 bto their unactuated positions and allow the anvil 410 to be reopened. Incertain instances, the cutting member 440 can contact the proximal slide422 a as the cutting member 440 is being retracted in order to nudge theproximal slide 422 a back onto the first threaded portion 465 a. Invarious instances, the end effector 406 can further include a threadedmember configured to ride on the shaft 464 and nudge the distal slide422 b back onto the second threaded portion 465 b. In any event, thethreaded portions of the shaft 464 can have the same thread pitch. Insuch instances, the portions of the end effector 406 displaced by theshaft 464 can move at the same speed. In other instances, one or more ofthe threaded portions of the shaft 464 can have a different thread pitchwherein, as a result, one or more of the components of the end effector406 can move at different speeds for a given rotational speed of theshaft 464.

As the reader will appreciate, the end effector 406 includes a singlerotational drive input which can close the anvil 410 in a first stage,deform the staples 14 in a second stage, and advance the knife 440 in athird stage. In certain instances, one or more of these stages may occurconsecutively. In at least one instance, one or more of these stages maynot overlap with each other. In various instances, one or more of thesestages may occur simultaneously. In at least one instance, one or moreof these stages may at least partially overlap with one or more otherstages. In some instances, it may be desired for the staple formingstage to at least partially occur before the cutting stage. In otherinstances, it may be desired for the staple forming stage to becompleted before the cutting stage begins. Such an embodiment may bedesired in order to prevent the tissue T from being cut prior to beingstapled. As described in greater detail below, certain embodiments caninclude two or more drive systems to perform the various operatingstages of an end effector.

FIG. 22 illustrates an embodiment of a shaftless end effector 506comprising a shaftless closure mechanism and a shaftless firingmechanism. The shaftless end effector 506 comprises a first jaw member508 a and a second jaw member 508 b. The first jaw member 508 acomprises an anvil 510 having a staple forming surface comprising aplurality of staple forming pockets therein. The second jaw member 508 bcomprises a longitudinal channel 542 configured to receive a staplecartridge 512 therein. The first jaw member 508 a and the second jawmember 508 b are pivotally coupled. The first jaw member 508 a comprisesa pin 515 coupled to a slot 516 formed in the lower jaw member 508 b.The pin 515 allows the first jaw member 508 a to move pivotally andvertically with respect to the second jaw member 508 b.

A rotatable shaft 564 extends longitudinally through the lower jawmember 508 b. The rotatable shaft 564 is coupled to a proximal slide 522a and a distal slide 522 b of the closure mechanism 520. The proximalslide 522 a and the distal slide 522 b can each comprise a cam 530. Eachcam 530 can comprise an angle configured to interface with one or morebeveled surfaces formed on the first jaw 8 a. The rotatable shaft 564comprises a drive end 566 which can be attached to a rotatable driveinput, such as rotatable drive input 568, for example. Similar to theabove, the rotatable drive input 568 can rotate the shaft 564 which can,in turn, move the proximal slide 522 a and the distal slide 522 blongitudinally towards a center point of the end effector 506. Themovement of the proximal slide 522 a and the distal slide 522 blongitudinally towards the center point of the shaftless end effector506 brings the cams 530 into contact with the first jaw 8 a in order todrive the anvil 510 into contact with the staple cartridge 512. Theanvil 510 can compress the staple cartridge 512 and deploy the staples14 through the target tissue “T”, as illustrated in FIG. 25. Such asystem can comprise a first drive system of the end effector 506configured to close the anvil 510 and fire the staples 14 in the endeffector 506.

Further to the above, the end effector 506 can include a second drivesystem configured to incise the tissue T and/or the staple cartridge512. Referring primarily to FIGS. 23 and 26, the shaftless end effector506 can comprise a cutting member, such as cutting member 540, forexample. The cutting member 540 can be longitudinally deployable withina channel formed in the second jaw member 508 b and/or the staplecartridge 512. In various instances, the cutting member 540 can includea longitudinal aperture, or clearance aperture, 570 extendingtherethrough. The drive shaft 564 can extend through the clearanceaperture 570 and the drive shaft 564 may not be operably engaged withthe cutting member 540. In various instances, the proximal slide 522 acan include a drive connector 576 extending therefrom. The driveconnection 576 can include an aperture 571 defined therein which can beconfigured to receive a rod 580. The rod 580 can be positioned within adrive input 578 wherein the drive input 578 can be attached to the driveconnector 576. Once the drive input 578 has been assembled to the driveconnector 576, the rod 580 can be advanced into the end effector 506 inorder to engage the cutting member 540, and/or a pusher member 541positioned intermediate the rod 580 and the cutting member 540. Invarious instances, the rod 580 and/or the pusher member 541 can abut thecutting member 540 and advance the cutting member 540 distally to incisethe cartridge 512 and/or the tissue T captured between the cartridge 512and the anvil 510. In certain instances, the rod 580 can be retractedand the cutting member 540 can be left in its advanced position. Inother instances, the rod 580 can comprise a distal attachment portionwhich can be configured to engage the cutting member 540, drive thecutting member 540 distally, and then pull the cutting member 540proximally to its unfired position, for example. In at least one suchembodiment, the cutting member 540 can include a socket defined thereinconfigured to receive the attachment portion of the rod 580. After thecutting member 540 has been retracted, the rod 580 can become detachedfrom the cutting member 540 by applying a sufficient force thereto.

As the reader can appreciate, the first drive system of the end effector506 can be configured to close the anvil 510 and fire the staples 14while the second drive system of the end effector 506 can be configuredto incise the tissue T captured within the end effector 506. The firstdrive system and the second drive system can be operated independentlyof one another. For instance, the first drive system can be operated bya clinician wherein the clinician can decide whether to operate and/orwhen to operate the second drive system. FIGS. 22, 25, and 26 illustratethe shaftless end effector 506 being transitioned between an openposition and a fired position. FIG. 22 illustrates the shaftless endeffector 506 in an open position. Target tissue “T” is positionedbetween the anvil 510 and the staple cartridge 512. The anvil 510 ispivoted from an open position to a partially-closed position by movingthe anvil 510 with a grasper, for example. The drive input 568 can beattached to the drive end 566 of the shaft 564 and the drive input 578can be attached to the drive connector 576 at any suitable moment duringthe use of the surgical instrument. In some instances, one or both ofthe drive input 568 and the drive input 578 can be attached to the endeffector 506 before the end effector 506 is positioned within a surgicalsite. In various instances, one or both of the drive input 568 and thedrive input 578 can be attached to the end effector 506 after the endeffector 506 has been positioned within a surgical site. In certaininstances, the drive input 568 can be assembled to the drive end 566independently of the drive input 578 being assembled to the drive end576. In other instances, the drive input 568 and the drive input 578 cancomprise an actuator assembly that can permit the drive input 568 andthe drive input 578 to be assembled to the end effector 506simultaneously. In use, the drive input 568 is actuated in order torotate the rotatable shaft 564 and drive the proximal slide 522 a andthe distal slide 522 b longitudinally towards a center point of the endeffector 506. As discussed above, the cams 530 on the proximal slide 522a and the distal slide 522 b can contact the first jaw 8 a to move theanvil 510 toward the staple cartridge 512 to form the staples asillustrated in FIG. 25. Also, in use, the drive input 578 is actuated inorder to advance the firing member 540. In certain instances, the driveinput 568 and the drive input 578 can be operated sequentially. In atleast one instance, the drive input 568 can be operated and then thedrive input 578 can be operated. In certain instances, the drive input578 may not be operated until after the operation of the drive input 568has ended. In at least one such instance, the drive input 568 can beoperated to completely form, or suitably form, the staples 14 before thedrive input 578 is operated to advance the knife 540. In variousinstances, the operation of the drive input 568 and the drive input 578can at least partially overlap. In at least one such instance, the driveinput 568 can be operated and, during the operation of the drive input568, the drive input 578 can be operated.

FIG. 27 illustrates an embodiment of an integrated closure and firingmechanism 680 for interfacing with a closure system 620 of the shaftlessend effector 606 illustrated in FIG. 28. The end effector 606 comprisesa first jaw member 608 a, a second jaw member 608 b, and a frame 694.The first jaw member 608 a comprises an anvil 610. The second jaw member608 b comprises a longitudinal channel 642 configured to receive astaple cartridge 612 therein. Referring to FIGS. 28, 30, and 32, thefirst jaw member 608 a and the second jaw member 608 b are pivotallycoupled by a pivot pin 615. Referring primarily to FIG. 32, the pin 615extends from the frame 694 and the first and second jaw members 608 a,608 b are rotatably coupled to the frame 694 by the pin 615. The firstjaw member 608 a and the second jaw member 608 b are pivotally moveablewith respect to a center axis “A”. A shaftless closure system 620 islocated at the proximal end of the shaftless end effector 606. Theshaftless closure system 620 comprises a rotatable collar 690 comprisingone or more threads 698 configured to rotatably interface with one ormore threads 696 formed on the first jaw member 608 a and the second jawmember 608 b. In at least one instance, the threads 696 can comprise acontinuous set of threads which extends around a perimeter defined bythe first jaw member 608 a and the second jaw member 608 b. Rotation ofthe rotatable collar 690 in a first direction pivots the first jawmember 608 a and/or the second jaw member 608 b towards the central axis“A”, as illustrated in FIG. 30. Rotation of the collar 690 in a second,or opposite, direction pivots the first jaw member 608 a and/or thesecond jaw member 608 b away from the axis “A”, as illustrated in FIG.29. As described in greater detail below, the collar 690 can include aconnection portion that can be operably attached to a drive input. Theend effector 606 can further include a cutting member 640 configured toincise the staple cartridge 612 and/or the tissue captured between thecartridge 612 and the anvil 610. The cutting member 640 can include aconnection portion, such as connection member 643, for example, whichextends proximally from the cutting portion 672 of the cutting member640. As described in greater detail below, the connection member 643 canbe operably attached to a drive input. In various instances, the frame694 can include a longitudinal aperture 693 defined therein wherein theconnection member 643 can be slideably received within the aperture 693.

Referring primarily to FIG. 27, the firing mechanism 680 can include aframe 682, a rotatable outer drive 686, and a translatable inner drive688. Referring to FIGS. 28-30, the rotatable collar 690 can include anopening 695 defined therein which can be configured to receive the frame682 of the firing mechanism 680. In various instances, the frame 682 canbe closely received within the opening 695. In certain instances, theframe 682 can include a longitudinal aperture 681 defined therein whichcan be configured to receive at least a portion of the frame 694 of theend effector 604. Similar to the above, the frame 694 can be closelyreceived within the aperture 681 of the frame 682. In various instances,the frame 694 and the frame 682 can be press-fit together. In certaininstances, the frame 682 can be press-fit between the frame 694 and thecollar 690. In some instances, a bayonet connection can be formedbetween the frame 682 and the frame 694. In at least one embodiment, theframe 694 can include one or more bayonet slots 692 defined thereinwhich can each be configured to receive a post 699 extending inwardlyfrom the frame 682. In order to assemble the frame 682 to the frame 694,the posts 699 can be positioned within the slots 692 and pushed distallyuntil they reach a turn or bend in the slots 692. At such point, theframe 682 can be rotated or twisted in order to lock the posts 699within the slots 692. In order to disconnect the frame 682 from theframe 694, the frame 682 can be rotated in the opposite direction tomove the posts 699 into an unlocked position such that the frame 682 canthen be pulled proximally away from the frame 694.

As discussed above, the collar 690 can comprise a connection portion. Invarious instances, the collar 690 can comprise one or more drive slots691 defined therein which can be configured to receive at least aportion of the rotatable outer drive 686 of the firing mechanism 680. Incertain instances, the rotatable outer drive 686 can include one or moredrive tabs 687 which can be positioned within the drive slots 691. In atleast one instance, the collar 690 can include a first drive slot 691located on a first side of the collar 690 and a second drive slot 691located on a second, or opposite, side of the collar 690 and,correspondingly, the rotatable outer drive 686 can include a first drivetab 687 positionable within the first drive slot 691 a second drive tab687 positionable within the second drive slot 691. In use, the drivetabs 687 can transmit rotational motion from the rotatable outer drive686 to the rotatable collar 690. In various instances, the drive tabs687 can be closely received within the drive slots 691 such that thedrive tabs 687 can engage the sidewalls of the drive slots 691 that theyare positioned within. In use, the outer drive 686 can be rotated in afirst direction in order to rotate the collar 690 in a first directionand close the end effector 606. As outlined above, the outer drive 686can be utilized to close the end effector 606, compress the cartridge612, and deform the staples 14. At any suitable point during the use ofthe end effector 606, the outer drive 686 can be rotated in a second, oropposite, direction in order to rotate the collar in a second, oropposite, direction and open the end effector 606.

As discussed above, the cutting member 640 can include a connectionmember 643. In various instances, the connection member 643 can includea connection slot 644 defined therein which can be configured to receiveat least a portion of the translatable inner drive 688 of the firingmechanism 680. In certain embodiments, the inner drive 688 can include adrive end 684 which can be releasably retained in the connection slot644. As illustrated in FIGS. 29 and 30, the inner drive 688 can beinserted into the frame aperture 693 to connect the drive end 684 to thecutting member 640. In use, the inner drive 688 can be pushed distallyin order to push the cutting member 640 distally and transect the staplecartridge 612 and/or the tissue positioned between the staple cartridge612 and the anvil 610. In various instances, the inner drive 688 may beoperated after the outer drive 686 is operated. In at least one suchinstance, the staples 14 can be completely formed before the cuttingmember 640 is advanced. In other instances, the inner drive 688 and theouter drive 686 can be operated simultaneously.

In use, the rotatable collar 690 may or may not be able to pivot thejaws 608 a and 608 b into their completely closed positions. Suchinstances can typically arise when the tissue captured between the jaws608 a and 608 b is thick. In various embodiments, the cutting member 640can include one or more gap-setting flanges, such as flanges 641 a and641 b, for example, which can facilitate the closure of the jaws 608 aand 608 b. More particularly, the cutting member 640 can include a firstgap-setting flange 641 a which can be configured to engage the first jaw608 a as the cutting member 640 is advanced distally. In variousinstances, the first flange 641 a, the second flange 641 b, and thecutting portion 672 can comprise an I-shaped or I-beam configuration,for example. Referring primarily to FIG. 31, the first flange 641 a canslide within a slot defined in the top surface of the first jaw 608 a.Similarly, the cutting member 640 can include a second gap-settingflange 641 b which can be configured to engage the second jaw 608 b asthe cutting member 640 is advanced distally. Referring primarily to FIG.31, the second flange 641 b can slide within a slot defined in the topsurface of the second jaw 608 b. As the cutting member 640 is advanceddistally, the flanges 641 a and 641 b can control, or set, the distancebetween the first jaw 608 a and the second jaw 608 b. In variousinstances, the tissue captured within the end effector 606, the staplecartridge 612, and/or a biasing spring of the end effector 606 can biasthe jaws 608 a and 608 b outwardly against the flanges 641 a and 641 b,respectively. Despite this outward bias, the cutting member 640 can movethe jaws 608 a and 608 b inwardly and/or hold the jaws 608 a and 608 bin their fully-closed positions. Some embodiments are contemplated inwhich the advancement of the cutting member 640 may be sufficient toclose the jaws 608 a and 608 b, fire the staples 14, and incise thetissue T, for instance.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

Preferably, the invention described herein will be processed beforesurgery. First, a new or used instrument is obtained and if necessarycleaned. The instrument can then be sterilized. In one sterilizationtechnique, the instrument is placed in a closed and sealed container,such as a plastic or TYVEK bag. The container and instrument are thenplaced in a field of radiation that can penetrate the container, such asgamma radiation, x-rays, or high-energy electrons. The radiation killsbacteria on the instrument and in the container. The sterilizedinstrument can then be stored in the sterile container. The sealedcontainer keeps the instrument sterile until it is opened in the medicalfacility.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples. Further, this application is intended to cover suchdepartures from the present disclosure as come within known or customarypractice in the art to which this invention pertains.

What is claimed is:
 1. An end effector and a shaft configured to staplepatient tissue, wherein said end effector is configured to be introducedinto a treatment area through an opening in the patient, and whereinsaid end effector comprises: a channel configured to receive a staplecartridge therein; an anvil; a first jaw; a second jaw movable relativeto said first jaw between an unclamped position and a clamped position,wherein said second jaw comprises: a proximal pivot end rotatablycoupled to said first jaw; and a movable distal end; a cutting member; aclosure system configured to engage said movable distal end of saidsecond jaw and said proximal pivot end of said second jaw; and a firstdrive system comprising a first input connector, wherein said firstdrive system is configured to operate said closure system and move saidsecond jaw to said clamped position, a second drive system comprising asecond input connector, wherein said second drive system is configuredto move said cutting member relative to said end effector; wherein saidshaft is configured to be inserted into the treatment area throughanother opening in the patient, and wherein said shaft comprises; afirst actuator configured to be coupled to said first input connector ofsaid first drive system after said end effector and said shaft areintroduced into the treatment area; and a second actuator configured tobe coupled to said second input connector of said second drive systemafter said end effector and said shaft are introduced into the treatmentarea, wherein said first drive system and said second drive system areoperable independently of one another.
 2. The end effector and shaft ofclaim 1, wherein said staple cartridge comprises a plurality of staplesremovably stored therein.
 3. An end effector and a shaft configured tostaple patient tissue, wherein said end effector is configured to beintroduced into a treatment area through an opening in the patient, andwherein said end effector comprises: a jaw assembly, comprising: achannel configured to receive a staple cartridge therein; an anvil,comprising; a proximal pivot end; and a movable distal end; and arotational joint connecting said anvil and said channel; a knife membermovable relative to said end effector; a closure system configured toengage said movable distal end of said anvil and said proximal pivot endof said anvil to close said jaw assembly; and a first drive systemincluding a first input connector, wherein said first drive system isconfigured to operate said closure system; a second drive systemincluding a second input connector, wherein said second drive system isconfigure to operate said knife member wherein said shaft is configuredto be inserted into the treatment area through another opening in thepatient, and wherein said shaft comprises; a first actuator configuredto be coupled to said first input connector of said first drive systemafter said end effector and said shaft are introduced into the treatmentarea; and a second actuator configured to be coupled to said secondinput connector of said second drive system after said end effector andsaid shaft are introduced into the treatment area, and wherein saidfirst drive system and said second drive system are operableindependently of one another.
 4. The end effector and shaft of claim 3,wherein said staple cartridge comprises a plurality of staples removablystored therein.
 5. An end effector configured to be introduce into asurgical site through an opening in a patient, wherein said end effectoris not attached to a surgical instrument as it passes through saidopening into said surgical site, and wherein said end effectorcomprises: a channel configured to receive a staple cartridge therein;an anvil; a first jaw; a second jaw movable relative to said first jawbetween an unclamped position and a clamped position, wherein saidsecond jaw comprises: a proximal pivot end rotatably coupled to saidfirst jaw; and a movable distal end; a cutting system; a closure systemconfigured to engage said movable distal end of said second jaw and saidproximal pivot end of said second jaw; and a first drive systemconfigured to operate said closure system and move said second jaw fromsaid unclamped position to said clamped position and a second drivesystem configured to operate said cutting system, wherein a firstactuator can be coupled to a first input connector of said first drivesystem after said end effector is inserted through said opening intosaid surgical site, wherein a second actuator can be coupled to a secondinput connector of said second drive system after said end effector isinserted through said opening into said surgical site, and wherein saidfirst drive system and said second drive system are operableindependently of one another.
 6. The end effector of claim 5, whereinsaid staple cartridge comprises a plurality of staples removably storedtherein.
 7. An end effector configured to be introduced into a treatmentarea of a patient through an opening in the patient, wherein said endeffector comprises: a channel configured to receive a staple cartridgetherein; an anvil comprising a staple forming surface; a first jaw; asecond jaw movable relative to said first jaw between an unclampedposition and a clamped position, wherein said second jaw comprises: aproximal pivot end rotatably coupled to said first jaw; and a movabledistal end; a cutting member; a cutting system configured to move saidcutting member relative to said end effector; a closure systemconfigured to engage said movable distal end of said second jaw and saidproximal pivot end of said second jaw; a first drive system comprising afirst input connector, wherein said first drive system is configured tooperate said closure system and move said second jaw from said unclampedposition to said clamped position; a second drive system comprising asecond input connector, wherein said second drive system is configuredto operate said cutting system and move said cutting member relative tosaid end effector; first means for actuating said first drive system;and second means for actuating said second drive system, wherein saidfirst means for actuating said first drive system is attachable to saidfirst input connector of said end effector after said end effector hasbeen introduced into the treatment area through the opening in thepatient, wherein said second means for actuating said second drivesystem is attachable to said second input connector of said end effectorafter said end effector has been introduced into the treatment areathrough the opening in the patient, and wherein said first means andsaid second means are operable independently of one another.
 8. The endeffector of claim 7, wherein said staple cartridge comprises a pluralityof staples removably stored therein.
 9. An end effector, comprising: astapling assembly, comprising: a first jaw, comprising: a frame; acartridge channel positioned in said frame; and a staple cartridgeremovably stored in said cartridge channel; and a second jaw, comprisingan anvil, comprising: a proximal pivot end rotatably coupled to saidframe; a movable distal end; and staple forming pockets; and a drivesystem, comprising: an actuator; a rotatable shaft operably positionedwithin said frame of said first jaw, wherein said rotatable shaft isconfigured to rotate in response to an actuation of said actuator; aproximal cam operably engaged with said rotatable shaft, wherein saidproximal cam is configured to move distally and engage said anvil toperform a clamping motion when said rotatable shaft is rotated; and adistal cam operably engaged with said rotatable shaft, wherein saiddistal cam is configured to move proximally and engage said anvil duringsaid clamping motion, and wherein said proximal cam and said distal cammove simultaneously when said rotatable shaft is rotated.
 10. The endeffector of claim 9, wherein said staple cartridge comprises a pluralityof staples removably stored therein.